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Bacteriuria in elderly institutionalized men.

L E Nicolle, J Bjornson, G K Harding

    The New England Journal of Medicine
    |December 8, 1983
    PubMed
    Summary
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    Asymptomatic bacteriuria is common in elderly men living in nursing homes. Treatment for this condition is often ineffective and unnecessary, with no significant impact on mortality or infectious morbidity.

    Area of Science:

    • Geriatric Medicine
    • Infectious Diseases
    • Urology

    Background:

    • Bacteriuria is common in elderly institutionalized men.
    • The optimal management of asymptomatic bacteriuria in this population is not well-defined.

    Purpose of the Study:

    • To determine the occurrence and optimal management of bacteriuria in noncatheterized male geriatric residents.
    • To evaluate the effectiveness of single-dose therapy and subsequent treatment for bacteriuria.

    Main Methods:

    • Monthly urine samples were collected from 88 male residents over two years.
    • Patients received single-dose therapy (trimethoprim/sulfamethoxazole or tobramycin) or were randomized to receive further therapy or no therapy after relapse or treatment failure.

    Main Results:

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    • Prevalence of bacteriuria was 33%, with an incidence of 45 infections per 100 patients per year.
    • Single-dose therapy resulted in a high rate of relapse (40) and treatment failure (11).
    • Subsequent therapy did not significantly improve bacteriuria-free status compared to no therapy, with similar mortality and infectious morbidity.

    Conclusions:

    • Asymptomatic bacteriuria is highly prevalent in elderly institutionalized men.
    • Current therapeutic approaches for asymptomatic bacteriuria in this population are neither necessary nor effective.
    • Further research is needed to understand the long-term implications and appropriate management strategies.